Urticaria: What your doctors won’t tell you about Chronic Urticaria
Urticaria also called nettle-rash or hives or wheels in a common language, simply means itching with a rash. Medically, urticaria may be defined as skin eruption, which is allergic (or non-allergic) in origin and is characterized by profound itching, red circular or irregularly shaped eruptions on any part of the body.
Urticaria is an allergic or non-allergic immunological disease, shown on the skin. Characteristically the skin eruptions are erythematous, raised above the skin level, with intense itching, and usually worsened by itching with slight local warmth. It can be acute or chronic; largely having a tendency to recur frequently for many months or years.
These eruptions can remain on the body for a variable period, anywhere from a few seconds to even hours. They have a tendency to disappear and reappear. They tend to disappear without leaving behind any trace.
Click on the image to enlarge the view
Location and duration:
Well, urticaria may appear on any part of the skin. Angioedema is a condition when deep tissues are affected. The typical lesions may last for one minute to half an hour. Some may last even longer. Some patients may get the eruptions once in a while and some may have it many times during the day. It may be restricted to a couple of spots in some patients, while some may have widespread rashes appearing for days or even months together.
There are acute, sub-acute, chronic, and recurring variants as far as the frequency and duration are concerned.
Histopathological view:
Under the microscope, a typical urticarial rash may exhibit perivascular, cellular infiltrate consisting of lymphocytes and eosinophils, which is indicative of its allergic behavior. There are findings related to edema (swelling) and mucosal inflammation.
Urticaria: The Inner War:
The urticaria rash is a symptom of an allergic and immunological event taking place at the dermal level. The exact understanding is elusive to an extent. In brief, urticaria is a hypersensitive reaction due to histamine release. The histamine release could be from the mast cells when antigens and antibodies (IgM or IgG) combine to activate the immunological reaction. The histamine release could be IgE induced. There are certain drugs, pharmacological agents (e.g.: antibiotics, morphine, aspirin, etc.), food articles (proteins, milk products, etc.) Urticaria is a sign of antigen-antibody reaction.
During this process of antibody-antigen reaction, histamine and/or acetylcholine is generated which has the property of causing vessel dilatation (vasodilation) swelling, itching, pain, and rash.
What causes urticaria (hives) is more difficult to answer than what happens during urticaria, as we described on the earlier page. In almost half the cases we know what causes or induces urticaria; and half the time, the patients or we have no clue as to its exact causation.
It must be noted that Urticaria is not always allergic in nature. There are allergic and non-allergic causes of chronic urticaria. The non-allergic causes include auto-immunity-related, hormonally triggered, stress-triggered, exercise and temperature-based, and other factors.
We shall try to examine some of the most common exciting factors known to induce urticaria (hives), which may be grouped as:
Allergens:
A large number of allergens have been identified as causative agents for some cases of urticaria. It may be noted that urticaria is an individual hypersensitivity and the following factors may not cause urticaria in all urticaria-prone individuals.
Food allergens:
Milk, cheese, egg, protein products, wheat, cereals, certain daals as used in India, peas, orange, fish, chicken, etc. Synthetic and natural food additives and artificially-flavored food articles.
Urticaria and alcohol:
True anaphylactic reactions to alcohol (ethanol) are rare and most reactions to ingested alcoholic beverages are secondary to other chemicals in the beverage such as metabisulfite, papain, dyes, or yeasts. However, there are reports of true allergic reactions in which the offending agent was shown to be the ethanol itself. Generally, the symptoms of anaphylaxis occur in such patients following the ingestion of beer and/or wine. Urticaria rashes have been reported with ethanol ingestion, and hives on contact with ethanol have also been reported for some patients.
Environmental factors:
Exposure to pollen, house dust, buffalo dander, fungi, change in temperature, etc. is known as exciting factors. Extreme cold, heat, and pressure may also induce urticaria.
Drugs:
The major cause of urticaria is man-made drugs such as antibiotics (Penicillin), NSAIDs, anti-inflammatory drugs (aspirin, indomethacin), vaccinations, foreign sera, hormonal preparations, contraceptive pills, etc. Animals treated with penicillin excrete a small amount of it in the milk sufficient to cause urticaria in sensitive individuals.
Urticaria and cocaine:
There have been reports of morphine-induced hives in some people. Bronchospasm may occur in some patients who smoke cocaine or in those who inject heroin. This may occur more often in patients who have a previous history of asthma. Hypersensitivity pneumonitis to cocaine has also been described and is associated with elevated levels of IgE.
Infections and infestations:
Insect bites, Fungal, protozoal, frequent bacterial infections (Urinary tract), viral infections (Hepatitis), helminthiasis (worm infestations such as roundworms, tapeworms), etc. are factors known to cause urticaria. Domestic contact with pet animals should be examined as a cause of urticaria.
Synthetic products:
The use of personal products such as deodorant, perfume, talcum powder, cosmetic products, animal derivatives, and similar synthetic substances may induce this disorder.
Emotional factors:
Especially in chronic, recurring cases of urticaria, the role of emotional factors must be examined. Emotional stresses may directly or indirectly make one susceptible to developing a tendency to urticaria. The psychological factors may work as exciting, aggravating, or maintaining causes.
Autoimmune causes:
Chronic urticaria is now understood to have an autoimmune link. Presence of autoantibodies against Immunoglobulin E (IgE), CD23 (FceRII or Fc epsilon RII) which releases histamine, hence leading to chronic urticaria.
Systemic and general disease:
Urticaria in some cases may present as a sign of other systemic or general internal diseases such as hormonal disorders (hyperthyroidism), SLE, polycythemia, reticulosis, etc. In a certain variety of malignancies (cancer), urticaria may present as a precursor.
Idiopathic cause:
No list of causation is complete without adding a paragraph of 'Idiopathic' which simply implies causes that are unknown.
Urticaria Diagnosis
Clinical diagnosis is made by close examination of the skin eruptions. Once observed and experienced, the patients can also recognize urticaria.
The exact diagnosis in terms of its causation is made after careful, systematic case history, by the physician. The patient's cooperation is required to provide proper information and also by eliminating certain food products once suspected.
Careful case analysis and evaluation are required to make a correct diagnosis. A systematic history to evaluate the whole system ruling out certain systemic diseases such as endocrine disorders, malignancy, lupus, respiratory disease, other allergic disorders, etc. is called for. Hormonal study and thyroid profile may be indicated if the clinical picture so suggests. Ruling out an uncommon possibility of malignancy is supported by other clinical findings and factors are indicated at times.
A detailed clinical history running through the checklist of various causes and considering the individual as a whole is more important than superficial, symptomatic medication with anti-allergic medicines or cortisone.
Urticaria Treatment
Homeopathy offers research-proven and effective treatment for Chronic and Recurrent Urticaria. Patients with Chronic urticaria are almost always put at the mercy of lifelong use of antihistamine medicines or cortisone by regular doctors. Once started, it becomes almost impossible to stop it even for a couple of days. You need treatment that is more than just antihistamines. That is homeopathy.
The Homeopathy Treatment
The homeopathic treatment for Chronic Urticaria is promising. It is much more advanced and more scientific as it is not aimed at relieving the symptoms but treating the disease at the immunological level. The treatment plans thus designed are addressed towards correcting the immune system, in turn treating Urticaria from within.
Dr Rajesh Shah, M.D. has researched Chronic Urticaria for over 25 years. His research-based molecules have an international patent pending. His unique treatment protocol is made available to patients of Urticaria the world over. At this point, there are patients from 127 countries under Dr Shah's care, which has been a world record.
The duration of treatment:
The total length of treatment varies from case to case, depending on the following factors:
- Duration of Urticaria
- Allergic or non-allergic nature
- The extent of spread (Mild, moderate, or severe. Cases with frequent attacks of Angioedema are more difficult to treat)
- Current and past medicines (Antihistamines or cortisone)
- General health and associated diseases
One may expect a definite change in about one to three months, in chronic cases. Acute cases generally show results in hours. The total length of medication for Chronic Urticaria may be anything between four to eight months or longer.
Why homeopathy for Urticaria?
The major benefits of homeopathy could be summarized as under :
- It offers an excellent treatment which has a success rate of over 80 to 85%
- It offers immuno-correction hence giving deep-level healing
- It offers a long-lasting cure instead of temporary relief.
- It is absolutely harmless, safe, and non-toxic.
As established earlier, urticaria is nothing but an external expression of internal, immunological disturbance, it also implies that the treatment of urticaria should also be based on the inner level consideration. It just can not be the symptomatic eradication of the urticarial rash. The homeopathic treatment is precisely organized on a similar philosophy.
The homeopathy system does not believe in treating urticaria superficially merely with some anti-histamines or steroids.
The Homeopathic Approach: As a rule, homeopathy never looks at urticaria as a local disease. Urticaria has been considered as a local expression of a systemic disturbance. As per classical homeopathy, we believe in constitutional prescribing. This calls for an individual case study in every case of urticaria.
Chronic urticaria and its long-term treatment
Chronic and recurring urticaria is a challenging problem for the medical world as on most occasions the exact cause remains unknown. What causes urticaria is more difficult to answer than what happens during urticaria, as we described on the earlier page. In almost half the cases we know what causes or induces urticaria; and half the time, we or the patients have no clue to its exact causation. We shall try to examine some of the most common exciting factors known to induce urticaria, which may be grouped as :
Allergens :
A large number of allergens have been identified as causative agents for some cases of urticaria. It may be noted that urticaria is an individual hypersensitivity and the following factors may not cause urticaria in all urticaria-prone individuals.
Food Allergens:
Milk, cheese, egg, protein products, wheat, cereals, certain daals as used in India, peas, orange, fish, chicken, etc. Synthetic and natural food additives and artificially flavored food articles.
Environmental Factors:
Exposure to pollen, house-dust, buffalo dander, fungi, change in temperature, etc. is known as exciting factors. Extreme cold, heat, pressure may induce urticaria.
Drugs: Man-made drugs are the major cause of urticaria. Antibiotics (Penicillin), anti-inflammatory medicines (aspirin, indomethacin), vaccinations and foreign sera, hormonal preparations, contraceptive pills, etc are a few common ones. Animals treated with penicillin excrete a small amount of it in the milk sufficient to cause urticaria in sensitive individuals.
Infections and Infestations:
Insect bites, Fungal, protozoal, frequent bacterial infections (Urinary tract), viral infections (Hepatitis), helminthiasis (worm infestations such as roundworms, tapeworms), etc. are factors known to cause urticaria. Domestic contact with pet animals should be examined as a cause of urticaria.
Synthetic Products: The use of personal products such as deodorant, perfume, talcum powder, cosmetic products, animal derivatives, and similar synthetic substances may induce this disorder.
Emotional Factors:
Especially in chronic, recurring cases of urticaria, the role of emotional factors must be examined. Emotional stresses may directly or indirectly make one susceptible to developing a tendency to urticaria. The psychological factors may work as exciting, aggravating, or maintaining cause.
Systemic and General Disease:
Urticaria in some cases may present as a sign of other systemic or general internal diseases such as hormonal disorders (hyperthyroidism), SLE, polycythemia, reticulosis. In a certain variety of malignancies (cancer), urticaria may present as a precursor.
Idiopathic Cause:
No list of causation is complete without adding a paragraph of 'Idiopathic' which simply implies those causes which are unknown. Urticaria is one of the many diseases of which the exact cause if not fully understood.
Dermatographism in urticaria
A dermatographism is a form of urticaria expression where one is able to write on the skin. It is nothing but a heightened sensitivity of skin whereby when pressed with an object or fingernail, the skin shows raised eruptions of urticaria, which may remain on the skin for some time. Writing lines and words on skin expressing urticaria is called dermatographism.
Dermatographism is observed in about 5% of urticaria patients. The writer of this article suspects based on experience that it is likely to be more as many patients may not experiment with pressing their skin with such objects.
Symptoms:
The typical appearance of dermatographism is shown in a picture of one of the patients treated at Life Force. The eruptions, in this case, are linear, raised inflamed, swollen in look which may be with or without itching.
Some of the patients may not have experienced such writing on the skin but may present with pressure urticaria.
Causes:
What goes on the skin writing?
Well, dermatographism is shown on the skin as the result of a complex play of immune cells from behind the skin. Usually, in response to the allergy (and allergens) blood cells release histamine, which leads to urticaria. However, in the case of dermatographism, it is believed that the mast cells release histamine without any allergens. This happens due to the weak membrane of mast cells which is responsible for histamine release due to pressure. (Mast cells are normal cells residing in the skin tissues and used for the healing of wounds.)
The exact cause of dermatographism is not fully understood. The factors which may trigger are more or less the same as those of urticaria, as explained on this website.
Symptoms:
Symptoms are lines and words (whatever one writes!) on the skin, with raised hives, associated with itching and swelling. It may last for a few minutes to hours or rarely days. In some cases, there may be the simultaneous appearance of hives elsewhere on the skin as well.
The tendency of having dermatographism may last for months or years.
Treatment of dermatographism:
a. Conventional treatment for Dermatographism :
The treatment same as that for urticaria, which includes antihistamines, H1 or H2 antagonists, and cortisone. With the symptomatic approach, dermatographism has been found to be very difficult to treat as far as its recurring tendency is concerned.
b. Homeopathic treatment for Dermatographism
Homeopathic treatment aims at treating the fundamental tendency of having dermatographism, where this tendency is understood to be an expression of the deeper level of immunological disturbance. The treatment is different than treating simple cases of urticaria. Another level of medicines is called for.
The results in the cases are Dermatographism using homeopathy are positive.
What your doctors won’t tell you about Chronic Urticaria
If you have suffered from Chronic Urticaria, you are most likely to visit a conventionally trained dermatologist doctor. He or she may have certain opinions about your Chronic Urticaria and its treatment based on the information gathered through medical training and experience. Unfortunately, conventional doctors get exposure only to conventional therapies. As a result, any alternative solutions to Chronic Urticaria are never taught to or learned by conventional doctors.
Also, the mindset of the conventional doctors takes such a shape that they often tend to think that there exists nothing beyond the conventional treatment, especially when it comes to the treatment of Chronic Urticaria in particular and many chronic diseases in general.
As a result, knowingly or unknowingly, they become instrumental in depriving patients of the benefits of other alternatives, especially homeopathy.
Let us see what your doctors will or won’t tell you about Chronic Urticaria :
(They will tell you) Anti-histamines and cortisone are the most effective and probably the only treatment for Chronic Urticaria.
It is not fully correct, it is partly correct. Antihistamines do help but are temporary. It treats urticaria on day to day baseâ or to the extent ofâ an hourly basis. The moment the effect of antihistamine is over the urticaria rash would return. Unfortunately, it is true, even if you have taken antihistamines for even five years. I see patients who have been taking antihistamines for over ten years and they cannot stop it for ten days!
Homeopathy offers an excellent treatment for Chronic urticaria, that your doctor might not know or tell you largely due to ignorance.
(They will tell you) Cortisone will cure chronic urticaria.
Not really. Cortisone will suppress urticaria. In most cases of chronic urticaria, it will resurface on stopping cortisone, which the doctors might not tell you. (Click here for adverse effects of cortisone.)
(They won’t tell you) The use of cortisone makes chronic urticaria more resistant. It can increase urticaria is in some cases.
Unfortunately, hardly any doctor will tell you that as you use cortisone for Chronic Urticaria could make it all the more difficult to treat. Cortisone being an immunosuppressive therapy, it suppresses histamine release for some time, without curing the underlying cause. As a result, some eruptions get better instantly after using cortisone. However, more eruptions might appear that too with more intensity and more resistance, on stopping cortisone.
(They won’t tell you) When will you be able to stop Antihistamines...
Chronic urticaria patients are prescribed antihistamines. Most patients feel better with antihistamines. However, the challenge lies in stopping antihistamines and still sustaining improvement. Most doctors might not tell you that you may require taking antihistamines for months or years.
(Click here for adverse effects of antihistamines.)
(They won’t tell you) Stress has a great bearing on Chronic urticaria.
Very few doctors would probably tell you about the connection between stress and chronic urticaria. Even if they do, not many doctors would review your stress in an elaborate manner and relate how stress management would help treat urticaria. They might give you some tranquilizer, at the most.
(They won’t tell you) Homeopathy offers excellent treatment for chronic urticaria
Only those doctors who have personal experience using homeopathy or have seen patients getting treated with success using homeopathy; would suggest you to opt for homeopathy. Most of them would not suggest simply due to a lack of knowledge.
(They might tell you) Homeopathy does not work for Chronic urticaria.
It is very easy for anyone to comment negatively on any science. However, it can be considered valid only if the opinion comes either from professional training or personal experience.
Please ask your doctor, if the opinion is based on his or her personal training. Ask, if the doctor has evaluated clinical studies published in the homeopathic medical world. It is helpful to find out if such an opinion is arising out of serious experience or wishful assumption.
Now, when you visit your skin doctor next time, ask if he or she has studied homeopathy and its role in the treatment of chronic urticaria.